Using Ambulance Data for Violence Prevention: Technical Report

80 Pages·2017·4.41 MB·English

Using Ambulance Data
for Violence Prevention
Technical Report
Alex Sutherland, Lucy Strang, Martin Stepanek,
Chris Giacomantonio, Adrian Boyle
For more information on this publication, visit www.rand.org/t/RR2216
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Preface
In early 2015, West Midlands Police (WMP) received a grant from the Police Innovation Fund to bring
together key partners relevant to accessing, understanding and making the best use of ambulance data to
aid with the prevention of violence. This project was led by Chief Inspector Dave Twyford, the then
National Policing Lead for Gangs and the Criminal Use of Firearms. West Midlands Violence Prevention
Alliance (WMVPA) agreed to oversee and ‘champion’ the implementation of ambulance data sharing in
the West Midlands. Public Health England (PHE) and the West Midlands Ambulance Service NHS
Foundation Trust (WMAS) supported access to ambulance data and tracking of violence-related
outcomes. RAND Europe, Dr Adrian Boyle (Addenbrooke’s Hospital) and Dr Barak Ariel (University of
Cambridge) provided independent evaluation of the implementation of ambulance data-sharing and led
the development of practitioner guidance in this area. This report presents the technical findings from the
project.
Following an introduction to the background to the study and the use of health data to support violence
prevention initiatives, the report examines the requirements for access to health data (Chapter 3) and the
police, ambulance dispatch and emergency department (ED) admission datasets used by the research team
(Chapter 4). The report then sets out results from the process evaluation: factors contributing to changes
from the proposed project approach; barriers to data sharing; the WMP organisational restructuring; and
gaps in data provided by WMAS (Chapter 5). Next, the report compares police, ambulance and ED data
in terms of geographical coverage, overlap and discussed some potential uses of ambulance data by the
police (Chapter 6). The report concludes by reflecting on study results, limitations of the evaluation,
recommendations for applications of ambulance data and avenues of future research (Chapter 7).
More detail on project methods and additional data is included as appendices to this report, and
methodological limitations are noted where appropriate.
RAND Europe is a not-for-profit policy research organisation that aims to improve policy and decision-
making in the public interest through independent research and analysis. This report has been peer-
reviewed in accordance with RAND’s quality assurance standards. For more information about RAND
Europe or this document, please contact:

Dr Alex Sutherland
RAND Europe, Westbrook Centre, Milton Road, Cambridge CB4 1YG
Email: [email protected]
iii

Table of contents
Preface ..................................................................................................................................................... iii
Table of contents ....................................................................................................................................... v
Figures .................................................................................................................................................... vii
Tables .................................................................................................................................................... viii
Acknowledgements .................................................................................................................................. ix
Abbreviations used in this document ......................................................................................................... x
1. Summary ............................................................................................................................. 1
1.1. Results.......................................................................................................................................... 3
1.2. Recommendations ........................................................................................................................ 3
2. Introduction ........................................................................................................................ 5
2.1. Using ambulance data for violence prevention: background ......................................................... 5
2.2. Existing evidence on violence prevention as a public health initiative............................................ 6
2.3. Rationale for the RAND Europe ambulance data study ................................................................ 6
2.4. RAND Europe ambulance data study overview ............................................................................ 7
2.5. The potential value of ambulance data for violence prevention ..................................................... 8
2.6. Objectives and research tasks ...................................................................................................... 10
2.7. Report structure ......................................................................................................................... 11
3. Requirements for accessing ambulance data ......................................................................... 12
3.1. Prerequisites for access and implementation ............................................................................... 12
4. Understanding the datasets ................................................................................................. 15
4.1. Data sources ............................................................................................................................... 15
4.2. Geographical coverage of datasets ............................................................................................... 18
4.3. Data processing .......................................................................................................................... 21
4.4. Analysis steps .............................................................................................................................. 22
5. Process evaluation results .................................................................................................... 26
5.1. Process evaluation objectives and questions ................................................................................ 26
v
5.2. Factors contributing to changing the proposed approach ............................................................ 29
5.3. Findings from process evaluation ................................................................................................ 31
6. Comparing police, ambulance and ED data ......................................................................... 35
6.1. Geographical coverage of different datasets ................................................................................. 35
6.2. Descriptive statistics and trends .................................................................................................. 36
6.3. To what extent do police, ambulance and ED incidents overlap? ................................................ 40
6.4. Hotspots: one example of how ambulance data could be used by police ..................................... 43
7. Conclusion ........................................................................................................................ 49
7.1. Limitations ................................................................................................................................. 50
7.2. Recommendations ...................................................................................................................... 51
References ............................................................................................................................................... 54
Appendix 1 ............................................................................................................................................. 56
Appendix 2 ............................................................................................................................................. 58
Appendix 3 ............................................................................................................................................. 61
Appendix 4 ............................................................................................................................................. 64
Appendix 5 ............................................................................................................................................. 65
Appendix 6 ............................................................................................................................................. 66
Appendix 7 ............................................................................................................................................. 68

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Figures
Figure 1: Research study focus .................................................................................................................. 2
Figure 1: Research study focus .................................................................................................................. 8
Figure 2: Geographical coverage of available datasets – police (blue), CAD (green) and ED (red) – in
Wolverhampton (west), Birmingham (middle) and Coventry (east) ............................................... 20
Figure 3: Example of conversion between coordinates (blue dot) and postcode (black polygon) using the
postcode centroid (red dot) ............................................................................................................ 21
Figure 4: Example of a 200 m x 200 m spatial net in Wolverhampton city centre. Each red dot represents
a unique postcode .......................................................................................................................... 24
Figure 5: Representation of cases in Wolverhampton city centre 2012–2015; police (blue), CAD (green)
and ED (red) datasets .................................................................................................................... 36
Figure 6: Incidents in the police and CAD datasets by day of week ........................................................ 37
Figure 7: Incidents in the police and CAD datasets by time of day (share of all incidents) ...................... 37
Figure 8: Number of incidents in the police and CAD datasets by month .............................................. 38
Figure 9: Number of incidents in police, ED and CAD datasets over time ............................................. 38
Figure 10: Gender and age distribution in the CAD dataset, April 2016 to March 2017 ........................ 39
Figure 11: Severity of injuries and type of offence in the CAD dataset, April 2016 to March 2017 ........ 39
Figure 12: Records of assault-related injuries reported by clerical/clinical staff at Type 1 emergency
departments (ISTV data) vs ambulance call-outs in the CAD dataset............................................. 40
Figure 13: Assaults within the 21–25 years old age group in Wolverhampton from CAD dataset, 2012–
2015 (top panel); police dataset of all incidents, 2012–2015 (bottom panel) ................................. 45
Figure 14: Hot street segments in Wolverhampton with and without background in police dataset, 2012–
2015 .............................................................................................................................................. 47

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Tables
Table 1: CAD dataset variables ............................................................................................................... 16
Table 2: ED dataset variables .................................................................................................................. 17
Table 3: Police call-out dataset variables ................................................................................................. 18
Table 4: Overlap between the police, CAD and ED datasets using postcode referencing and six-hour time
nets................................................................................................................................................ 41
Table 5: Proportion of CAD and ED datasets incidents found in the police dataset using varying spatial
nets................................................................................................................................................ 42
Table 6: Spatial concentration of crime by postcode ............................................................................... 43
Table 7: Top 10 hot postcodes in ambulance data .................................................................................. 46
Table 8: PFR dataset variables ................................................................................................................ 56
Table 9: WMAS dataset initially requested by RAND Europe ................................................................ 64
Table 10: Caldicott Principles ................................................................................................................ 65
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Acknowledgements
The authors would like to thank the many people who have supported this project. First and foremost, we
would like to thank our research partners at the West Midlands Police and the Violence Prevention
Alliance, including Superintendent Simon Inglis, Chief Inspector Dave Twyford, Ciaran Walsh and Andy
Brumwell; and at the West Midlands NHS Ambulance Trust, Chris Kerr. We also thank Dr Adrian Boyle
and Dr Barak Arial for their guidance throughout the project, and our former RAND Europe colleague
Dr Chris Giacomantonio, who managed the research study in its early stages. We would also like to
express our gratitude to Dr Obaghe Edeghere of Public Health England and Dr Zara Quigg of the Public
Health Institute, Liverpool John Moores University for engaging with the project.

We also thank the Police Innovation Fund for the opportunity to conduct this piece of research.

Finally, we are grateful to our Quality Assurance reviewers, Professor Jonathan Shepherd from Cardiff
University and Dr James Fox from RAND Europe.

ix
Abbreviations used in this document
CAD Computer-Aided Dispatch
CSP Community Safety Partnership
ED Emergency Department
EGYV Ending Gang and Youth Violence
ISA Information Sharing Agreement
ISTV Information Sharing to Tackle Violence
LA Upper-tier Local Authorities
LSOA Lower Layer Super Output Areas
PHE Public Health England
PRF Patient Report Form
TIIG Trauma and Injury Intelligence Group
WMAS West Midlands Ambulance Service NHS Foundation Trust
WMP West Midlands Police
WMVPA West Midlands Violence Prevention Alliance
VRU Violence Reduction Unit

x